Medication competency of nurses according to theoretical and drug calculation online exams: A descriptive correlational study

doi:10.1016/j.nedt.2015.10.006

Nurse Education Today

Volume 36, January 2016, Pages 195-201

https://doi.org/10.1016/j.nedt.2015.10.006 Get rights and content

Highlights

•
The majority of the nurses mastered the theoretical knowledge needed in medication.
•
Five percent of the nurses struggled with passing the drug calculation exam.
•
The more the nurses implement medication, the better they do in the exams.
•
Targeted educational interventions are needed for nurses who struggle in the exams.

Summary

Background

Medication administration is an important task of registered nurses. According to previous studies, nurses lack theoretical knowledge and drug calculation skills and knowledge-based mistakes do occur in clinical practice. Finnish health care organizations started to develop a systematic verification processes for medication competence at the end of the last decade. No studies have yet been made of nurses' theoretical knowledge and drug calculation skills according to these online exams.

Objectives

The aim of this study was to describe the medication competence of Finnish nurses according to theoretical and drug calculation exams.

Design

A descriptive correlation design was adopted.

Participants and settings

All nurses who participated in the online exam in three Finnish hospitals between 1.1.2009 and 31.05.2014 were selected to the study (n = 2479).

Methods

Quantitative methods like Pearson's chi-squared tests, analysis of variance (ANOVA) with post hoc Tukey tests and Pearson's correlation coefficient were used to test the existence of relationships between dependent and independent variables.

Results

The majority of nurses mastered the theoretical knowledge needed in medication administration, but 5% of the nurses struggled with passing the drug calculation exam. Theoretical knowledge and drug calculation skills were better in acute care units than in the other units and younger nurses achieved better results in both exams than their older colleagues.

Conclusion

The differences found in this study were statistically significant, but not high. Nevertheless, even the tiniest deficiency in theoretical knowledge and drug calculation skills should be focused on. It is important to identify the nurses who struggle in the exams and to plan targeted educational interventions for supporting them. The next step is to study if verification of medication competence has an effect on patient safety.

Introduction

Medication administration is one of the most important tasks and responsibilities of registered nurses (Sung et al., 2008). At the same time, medication errors are an internationally significant cause of morbidity and mortality in hospitalized patients (Kohn et al., 2000) and especially in IV therapy (Dennison, 2007, McDowell et al., 2010). All registered nurses and midwives (henceforth nurses) in Finland are trained to be responsible for performing medication. Their expertise in medication, compared to other nurses (practical nurses, enrolled nurses, etc.), is intravenous (IV) therapy.

According to previous studies, nurses lack theoretical knowledge (Morrison-Griffiths et al., 2002, Brady et al., 2009, Keers et al., 2013) and drug calculation skills (Grandell-Niemi et al., 2006, Wright, 2007). Knowledge-based mistakes do occur (Taxis and Barber, 2003), and drug calculation is also a crucial skill as one mistake in calculation can lead to a fatal medication error (Glaister, 2007, McMullan et al., 2011). Hence, adequate medication competence is the basis for safe medication practice (Sulosaari et al., 2014). In this study, the focus is on nurses' theoretical knowledge and drug calculation skills in medication.

Section snippets

Background

Medication administration involves both the intellectual activity and the physical act of medication preparation or administration (Brady et al., 2009). In the literature, medication competence is defined as a complex combination of knowledge, skills, performance, values, attitudes, and decision-making competence (Cowan et al., 2005, Sulosaari et al., 2011).

The medication competence of nurses appears to vary depending on training and experience (Veräjänkorva, 2003, Khomeiran et al., 2006, Dyjur

Aim

The aim of the study was to describe the medication competence of nurses according to the theoretical and drug calculation online exams.

More specifically, the research questions of the study were as follows:

1.
What is the nurses' theoretical medication knowledge according to the online exam?
2.
What is the nurses' drug calculation skill level according to the online exam?
3.
What characteristics of the nurses or the exam are related to their medication competence according to the online exam

Design

A descriptive

Demographics

Table 2 presents the characteristics of the respondents.

Age at the time of answering (Min = 22; Max = 68 ; Mean = 42.08; SD = 10.61) were distributed into four groups with 10-year intervals. There were differences between the age of participants and the units (N = 2479; F = 10.431, df = 4, sig < 0.001). In the outpatient units, the mean of age (45.07 years) was almost 5 years more than in the acute care units (40.63) and in the clinical units (40.93).

Nurses' Theoretical Medication Knowledge According to the Online Exam

There was positive correlation between the drug calculation

Theoretical Knowledge Based on Results of This Study

The results of this study indicate that the majority of nurses master the theoretical knowledge needed in medication administration as defined by Finnish Ministry of Social Affairs and Health (2009). Theoretical knowledge is considered to be the basis of safe medication (Brady et al., 2009). Since the theoretical exam of this study had a conscious focus on IV therapy, which in particular has been proven to be a risk to medication safety (Taxis and Barber, 2003, Dennison, 2007), the nurses'

Limitations

The limitations of the study include the use of a single instrument to measure theoretical competence and drug calculation skills. The data for this study were collected from those exams only and from a restricted part of Finland. Hence, careful consideration is needed to determine whether the findings can be generalized to the whole population.

No conclusions can be made on nurses' overall competence in medication administration. Implementation of safe patient medication requires a number of

Conclusions

Medication administration is a complex procedure where theoretical knowledge and drug calculation skills act as equally important areas of competence. According to this study theoretical knowledge and drug calculations skills have positive correlation. The differences in theoretical knowledge and drug calculation skills found in this study were statistically significant, but not high. These results can be regarded as excellent from the point of view of medication safety. Nevertheless, even the

Conflict of Interest Statement

No conflict of interest has been declared by the authors.

Funding Statement

State Research Funding, Finland.

Acknowledgements

The authors would like to thank Lingsoft—company for editing of English language.

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¹: Study design, data collection, data analysis, drafting of manuscript.

²: Supervision.

³: statistics expert.

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Medication competency of nurses according to theoretical and drug calculation online exams: A descriptive correlational study

Highlights

Summary

Background

Objectives

Design

Methods

Results

Conclusion

Introduction

Section snippets

Background

Aim

Design

Demographics

Nurses' Theoretical Medication Knowledge According to the Online Exam

Theoretical Knowledge Based on Results of This Study

Limitations

Conclusions

Conflict of Interest Statement

Funding Statement

Acknowledgements

Nurse Educ. Today

Nurse Educ. Today

Nurse Educ. Today

Nurse Educ. Today

Int. J. Med. Inform.

Nurse Educ. Today

Collegian: J. R. Coll. Nurs. Austr.

Nurse Educ. Today

Nurse Educ. Today

Nurse Educ. Today

Understanding experience in nursing

J. Clin. Nurs.

Becoming a web-based learner: registered nurses' experiences

J. Adv. Nurs.

A literature review of the individual and systems factors that contribute to medication errors in nursing practice

J. Nurs. Manag.

Understanding and Conducting Research in the Health Sciences

A medication safety education program to reduce the risk of harm caused by medication errors

J. Contin. Educ. Nurs.

Maths for medications: an analytical exemplar of the social organization of nurses' knowledge

Nurs. Philos.